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Tuesday, September 15, 2009

Against Government Involvement in Health Care? Oh, are you really against Medicare?

While watching some of the news coverage yesterday, I saw the reporters putting the microphone in from of some of the protesters in Washington. Several of these people were clearly senior citizens, and several of them said that the government shouldn't be involved with our health care.

My reaction: YOU HYPOCRITES!

I think these people are taking for granted their Medicare benefits. They are potentially entitled to more financial compensation (Medicare as insurance payments) for their medical care then they have paid and are paying into the Medicare pot. The rest of the wage earners are paying with the Medicare deduction from their paychecks.

Senior citizens are more likely to need prescription medications than younger people. Now, thankfully, there is Medicare D, which helps pay for this benefit. One of my relatives was complaining about the "doughnut hole" in Medicare D. Yes, there is a significant out of pocket expense after a certain dollar amount is reached. But isn't she forgetting that in the previous years, after her husband lost his medical insurance, she was paying for ALL of these medications out of pocket? At one time she told me that she and her husband were paying about $500/month for prescriptions.

Patients who have certain conditions need to have lab tests periodically to make sure certain blood levels are in a healthy range. Medicare patients don't have to worry as much about the costs.

End of life illnesses often mean very high medical costs for the last year of life. Much of this is covered by Medicare, and if the patient also has a Medicare Supplement insurance policy, his family isn't stuck with a big debt after the patient passes away.

I think we take for granted a number of quality of life issues these days because of Medicare. Think of all the people you know who have had knee or hip replacements. The surgeries and hospital after care are expensive. The patients go to physical therapy to speed the recovery and increase the chances that the patients will have good mobility in the following years. They may get more enjoyment of life during their golden years if they can walk comfortably and play with their grandchildren. Joint replacement patients who are seniors can spend a few days in a rehabilitative nursing home immediately following release from the hospital if they wish, which often speeds the recovery and therapy. Who could afford these surgeries and therapies pre Medicare, when many people would have no insurance at all after retirement? One man I know, who is clearly "not poor" had an accident which severely injured his hip. He got by with reduced mobility so that he could wait until he qualified for Medicare before he had his hip replacement surgery.

Medicare patients who live in a nursing home are seen by a doctor every month, or in some practices, by a physician every other month, and a CNP on the off month. Those nursing home patients who are not on Medicare don't fall under a doctor visit requirement. Elderly nursing home patients get therapy evaluations when they enter the nursing home, paid for, of course, by Medicare.

Are there problems with Medicare? Of course. And we know that through the years the percentage of the costs paid for by Medicare has shrunk, which is a concern. But the purpose of this post is to highlight areas of care that we might be taking for granted after so many years of Medicare.

I am basing the above information on my own knowledge. I was a certified insurance counselor, helping senior citizens with coordinating their insurance coverage for several years. I have the personal knowledge of dealing with my mother's finances, especially with her medical bills. Actually, there have been no problems with the Medicare and supplemental insurance payments. I've seen my mother-in-law have a hip fracture, replacement, and nursing home care, and be able to have a very high quality of life afterwards. Actually, due to falls, she has been in the nursing home three times, gotten therapy, and moved back home each time. I doubt she would have recovered as well if there hadn't been the therapy paid for by Medicare.

And I've had extensive discussion with a Family Physican who is also board certified in Geriatrics and who has extensive experience with nursing home patients. His assesment of Medicare is that it requires care for a lot of people who would be neglected or overlooked without it.

3 comments:

Your words here certainly do ring true! I've been on Social security disability for the past six years, receiving Medicare for the past four years and for the last three years, I've had a supplemental insurance plan in effect. I've also had 3 major surgeries, oodles of tests and such plus regular checkups -none of which I would ever have been able to afford without medicare and now my supplemental plan too. People need to stop and think about some of the things they have access to and whether or not those things might just be "Government run" entities before going off the deep end.

Medicare has worked so well we don't think of it as being government run. But , of course it is. That is both its great strength and its biggest problem. Presidents and Congress feel a need to meddle with it. Bush tried to cut it back.It is always open to the whims of the government.